=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518856863
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORSY DDS , INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2025
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1010 E VISTA WAY STE B
-----------------------------------------------------
City | VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92084-4607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-659-6118
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1010 E VISTA WAY STE B
-----------------------------------------------------
City | VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92084-4607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-659-6118
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATIVE
-----------------------------------------------------
Name | AIRLEEN DIAZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 760-659-6118
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------